Urology · Minnesota

Urology commercial reimbursement in Minnesota

How Minnesota urology rates compare with the national market.

Urology in Minnesota

37 codes · 112 sampled providers
Index vs national
119
19% above
Rank among states
9 of 50
1 = highest
Codes above national
36 of 37
median code at 119%
Providers
112
sampled

What the data shows

1

Urology ranks 9th of 50 states in Minnesota with an index of 119 (100 = the specialty's national median), across 37 codes and 112 sampled providers.

2

Of the 37 urology codes with enough data in Minnesota, 36 pay above the national median and 1 below; the typical code sits at 119% of the national median.

3

Largest premium over the national median: CPT 51798 (Us urine capacity measure) at 145%; largest discount: CPT 93000 (Electrocardiogram complete) at 89%.

4

Measured against Medicare, Minnesota urology rates have a median of 200% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMinnesotaNationalGapProv.
51798
Us urine capacity measure
$31$21+45%84
99212
Office o/p est sf 10 min
$70$52+34%112
51729
Cystometrogram w/vp&up
$736$554+33%111
99204
Office o/p new mod 45 min
$259$197+32%112
99214
Office o/p est mod 30 min
$175$134+31%112

Lowest vs national

CodeMinnesotaNationalGapProv.
93000
Electrocardiogram complete
$23$26-11%108
64566
Neuroeltrd stim post tibial
$73$69+6%111
76872
Us transrectal
$200$188+6%111
76775
Us exam abdo back wall lim
$100$92+8%111
52224
Cystoscopy and treatment
$501$459+9%111

All urology codes in Minnesota

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMinnesotaNationalGap% of MedicareProvidersTINsLevel
CPT 51798
Us urine capacity measure
$31$21+45%244%84113
CPT 99212
Office o/p est sf 10 min
$70$52+34%117%112182
CPT 51729
Cystometrogram w/vp&up
$736$554+33%208%111179
CPT 99204
Office o/p new mod 45 min
$259$197+32%146%112182
CPT 99214
Office o/p est mod 30 min
$175$134+31%129%112182
CPT 99213
Office o/p est low 20 min
$120$92+30%126%112182
CPT 51728
Cystometrogram w/vp
$673$520+29%200%112182
CPT 99490
Chrnc care mgmt staff 1st 20
$78$60+29%118%111177
CPT 52332
Cystoscopy and treatment
$449$360+25%322%112183
CPT 99205
Office o/p new hi 60 min
$319$257+24%135%112182
CPT 99215
Office o/p est hi 40 min
$230$187+23%120%112182
CPT 99426
Prin care mgmt staff 1st 30
$94$77+23%139%110174
CPT 52310
Cystoscopy and treatment
$390$317+23%290%112182
CPT 99203
Office o/p new low 30 min
$153$125+22%130%112182
CPT 52287
Cystoscopy chemodenervation
$449$367+22%301%112180
CPT 20610
Drain/inj joint/bursa w/o us
$105$86+22%152%111178
CPT 52648
Laser surgery of prostate
$1,840$1,508+22%348%110178
CPT 50590
Fragmenting of kidney stone
$1,274$1,065+20%168%111180
CPT 76770
Us exam abdo back wall comp
$182$153+19%171%111178
CPT 52281
Cystoscopy and treatment
$396$334+19%290%112181
CPT 76856
Us exam pelvic complete
$175$148+18%166%111179
CPT 52356
Cysto/uretero w/lithotripsy
$775$657+18%212%112183
CPT 55874
Tprnl plmt biodegrdabl matrl
$303$257+18%212%111177
CPT 51702
Insert temp bladder cath
$72$61+18%315%111181
CPT 74178
Ct abd&plv wo cntr flwd cntr
$575$498+16%170%111175
CPT 52601
Prostatectomy (turp)
$1,357$1,181+15%258%111180
CPT 51720
Treatment of bladder lesion
$127$111+14%333%111181
CPT 52649
Prostate laser enucleation
$1,542$1,355+14%235%111179
CPT 76857
Us exam pelvic limited
$84$75+13%165%111178
CPT 51700
Irrigation of bladder
$87$77+12%332%111180
CPT 52000
Cystourethroscopy
$232$210+10%326%112183
CPT 55866
Laps surg prst8ect rpbic rad
$2,445$2,237+9%226%111180
CPT 52224
Cystoscopy and treatment
$501$459+9%285%111180
CPT 76775
Us exam abdo back wall lim
$100$92+8%165%111178
CPT 76872
Us transrectal
$200$188+6%167%111178
CPT 64566
Neuroeltrd stim post tibial
$73$69+6%281%111179
CPT 93000
Electrocardiogram complete
$23$26-11%149%108141

Frequently asked questions

How do Minnesota urology rates compare with the rest of the country?

Minnesota ranks 9th of 50 states with an index of 119; 36 of 37 codes are above the national median.

Which urology code has the biggest premium in Minnesota?

CPT 51798 (Us urine capacity measure), at 145% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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